• Wen-Han Kuo, Yi-Cheng Wu, Ching-Yang Wu, Kung-Chu Ho, Pin-Hsiu Chiu, Chih-Wei Wang, Chee-Jen Chang, Chih-Teng Yu, Tzu-Chen Yen, and Chieh Lin.
• Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, 5 Fu-Shin Street, Kueishan, Taoyuan 333, Taiwan.
• Acad Radiol. 2012 Jun 1; 19 (6): 685-92.

Rationale And ObjectivesResearch suggests that the semiquantitative determination of nodal (18)F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) may be useful for the assessment of mediastinal metastases in patients with non-small-cell lung carcinoma (NSCLC). The aim of this study was to evaluate the diagnostic ability of using different standardized uptake value (SUV) parameters in the detection of ipsilateral mediastinal (N2) disease.Materials And MethodsA total of 102 patients newly diagnosed with non-small-cell lung carcinoma who underwent (18)F-FDG PET/CT before surgery and had not received prior therapy were retrospectively included. All patients underwent surgical resection of the primary tumor and mediastinal lymph node dissection. On a station-based analysis, different SUV parameters (eg, mediastinal lymph node SUV, node/aorta SUV ratio, and node/liver SUV ratio) were evaluated using the histopathologic results as the reference standard. The optimal cutoff value for each SUV parameter was determined with receiver-operating characteristic curve analysis.ResultsThe areas under the receiver-operating characteristic curves were 0.674, 0.693, and 0.715 for node SUV, node/aorta SUV ratio, and node/liver SUV ratio, respectively (P < .05). With cutoff values of 3.15, 1.37, and 1.02 for node SUV, node/aorta SUV ratio, and node/liver SUV ratio, respectively, the sensitivity of (18)F-FDG PET/CT for N2 staging was 57.1%, 85.7%, and 71.4%, and specificity was 74.2%, 50.5%, and 61.9%.ConclusionsCompared to node SUV alone, the use of node/aorta and node/liver SUV ratios resulted in improved detection of N2 metastases. The two SUV parameters may potentially improve the diagnostic accuracy of (18)F-FDG PET/CT for the diagnosis of N2 disease in patients with non-small-cell lung carcinoma.Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

39 keywords...

hide…